To save mothers and their babies

Here’s a bit of good news to brighten the dark horizon: A measure seeking to provide health and nutrition services to pregnant women and babies during their first 1,000 days has been signed into law by President Duterte.

Under Republic Act (RA) No. 11148, or the “Kalusugan at Nutrisyon ng Mag-Nanay Act,” the country’s key health bodies are mandated to ensure access to adequate food, care and nutrition during the different pregnancy and life stages for both mother and child, starting from conception to the first 24 months of life.

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The services covered under RA 11148, also known as the First 1,000 Days Law, include antenatal care, maternal immunizations, counseling particularly on breastfeeding, provision of micronutrient and dietary supplements, and routine immunizations for babies.

The law puts emphasis on malnutrition and stunting, directing the Department of Health (DOH), the National Nutrition Council, the Department of Agriculture, and local government units to provide interventions especially to the poor and those in disaster or remote areas.

RA 11148 will help the Philippines meet the Social Development Goals (SDGs) set by the United Nations, including lowering the infant mortality rate (IMR). World Bank data show that as of 2017, the Philippines’ IMR was at 22 per 1,000 live births, slightly better than that of other Asian countries like Cambodia (25) and Bangladesh (27), but still lagging behind developed countries like Japan (2) and Singapore (2).

The IMR is an important indicator of a country’s overall health as it reflects the soundness of support institutions: Are there enough facilities for mother and child care especially during the first two years? How accessible are these especially to the poor?

Experts consider the first 1,000 days in a child’s life crucial because it is during this period that their mental and physical faculties are established.

In poor and developing countries like the Philippines, babies often suffer from malnutrition and poor hygiene, leading to stunting and diseases or, worse, death.

Stunting is “not a racial and genetic trait but a result of a lingering problem of chronic malnutrition among millions of Filipino children,” explains Save the Children Philippines. It says that there are about 3.6 million stunted and 800,000 malnourished Filipino children today, and that at least 95 children below 5 years old die every day due to preventable diseases caused by undernutrition.

The DOH points out that lack of universal immunization against these diseases — measles, tetanus, rubella and diphtheria, among others — has been a major cause of infant death.

There was a significant drop in immunization coverage in 2017, with only 70 percent of children aged 12-23 months receiving all basic vaccinations; this represents a seven-percentage-point decrease from 2013, in the reckoning of the UN Children’s Fund.

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The downtrend has continued this year, with the DOH reporting that only 50-60 percent of children received their scheduled vaccines as of February. The decrease is attributable to parents’ fears over vaccines administered for free by the government following the controversy over the dengue vaccine Dengvaxia.

Measles cases, for example, have risen at an alarming rate of 367 percent this year. As of November, 17,298 cases have been reported compared with 3,706 last year, according to the World Health Organization.

The world aims to reduce IMR under the SDGs to as low as 12 deaths per 1,000 live births by 2030.

The Philippines is halfway there, and has shown remarkable progress from 41 deaths per 1,000 in 1990 to 22 as of last year. Still, a lot remains to be done and the government should start by allocating the necessary budget to implement RA 11148.

Implementation is, after all, essential. As Sen. Grace Poe, coauthor of the Senate bill, put it: “Just like an infant, the future of this new law — whether or not it fulfills its mandate — lies in the first 1,000 days of its implementation. Without sufficient funding, the law cannot fulfill the program’s objectives.”

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